Individual provider Active NPI

Victor Russell Barnes, MD

  • Psychiatry Physician
  • Jacksonville, NC
National Provider Identifier
1568448041
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
9300022 Issued in NC
Practice address
472D Western Blvd
Jacksonville, NC 28546-6824
Phone
(910) 238-4513
Fax
(910) 238-4745
NPI assigned
Dec 16, 2005
Last updated
May 27, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 9300022 NC Primary

Addresses

Primary practice location

472D Western Blvd
Jacksonville, NC 28546-6824

Mailing address

472D Western Blvd
Jacksonville, NC 28546-6824
Phone (910) 238-4513

Other identifiers 2

IdentifierTypeStateIssuer
8913388MedicaidNC
13388OtherNCBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230727003605 NC Practitioner - Psychiatry 0749552669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Psychological and Psychiatric Health SRVS PAGroup PAC ID 9436059219, 17 clinicians

Practice addresses (Care Compare)

1703 Country Club Rd
Suite 204
Jacksonville, NC 28546-6006
Phone (910) 347-3010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9300022NCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Psychological and Psychiatric Health SRVS, PA Psychiatry CurrentSince May 27, 2023 Accepting new patients
Palms Wellness Center Inc Psychiatry Current Accepting new patients
Resolutions Counseling and Mediation Services, PLLC PastSince May 27, 2023 Accepting new patients

Locations

1703 Country Club Rd
Ste 204
Jacksonville, NC 28546
Phone (910) 347-3010

472D Western Blvd
Jacksonville, NC 28546
Phone (910) 238-4513

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1568448041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472D WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466824",
            "telephone_number": "910-238-4513",
            "fax_number": "910-238-4745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "472D WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466824",
            "telephone_number": "910-238-4513",
            "fax_number": "910-238-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "VICTOR",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "9300022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913388",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "13388",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.